Classifying energy insecurity among households with medical devices through latent class analysis

Abstract The growing prevalence of electricity-dependent durable medical equipment (EDME) in homes—such as oxygen concentrators, infusion pumps, and nebulizers—may widen health disparities. As climate change increasingly challenges electric grid reliability, understanding which EDME-dependent persons (EDPs) are most vulnerable to power outages becomes critical in addressing both health equity and climate resilience. Using data from 2,612 households in the 2020 Residential Energy Consumption Survey, we applied latent class analysis to identify distinct vulnerability profiles among EDPs. We identified four classes, with two experiencing energy insecurity but with different power outage preparedness probabilities and sociodemographic profiles. The most resilient yet energy-insecure class (20% of EDPs) consists primarily of homeowners with some alternative power sources (e.g., backup generators and solar panels). These findings suggest that interventions for homeowners should focus on reducing out-of-pocket energy costs and offering affordable financing options to help households invest in long-term energy solutions, including backup power. In contrast, the most vulnerable class (7.3% of EDPs) is comprised of renters who lack access to alternative power sources and are disproportionately families with children, households earning under $35,000 annually, or households with Black or Hispanic members. These findings suggest that resilience interventions targeting renters across all housing types could include small-sized portable backup power and medical baseline electricity rates, while simultaneously alleviating broader energy insecurity challenges among the most vulnerable EDPs.